Florida Senate - 2016 PROPOSED COMMITTEE SUBSTITUTE Bill No. SB 234 Ì406770*Î406770 576-01373-16 Proposed Committee Substitute by the Committee on Appropriations (Appropriations Subcommittee on Health and Human Services) 1 A bill to be entitled 2 An act relating to dental care; creating s. 381.4019, 3 F.S.; establishing a joint local and state dental care 4 access account initiative, subject to the availability 5 of funding; authorizing the creation of dental care 6 access accounts; specifying the purpose of the 7 initiative; defining terms; providing criteria for the 8 selection of dentists for participation in the 9 initiative; providing for the establishment of 10 accounts; limiting the number of new accounts that may 11 be established per fiscal year; requiring the 12 Department of Health to implement an electronic 13 benefit transfer system; providing for the use of 14 funds deposited in the accounts; requiring the 15 department to distribute state funds to accounts, 16 subject to legislative appropriations; authorizing the 17 department to accept contributions from a local source 18 for deposit in a designated account; limiting the 19 number of years that an account may remain open; 20 providing for the immediate closing of accounts under 21 certain circumstances; authorizing the department to 22 transfer state funds remaining in a closed account at 23 a specified time and to return unspent funds from 24 local sources; requiring a dentist to repay funds in 25 certain circumstances; authorizing the department to 26 pursue disciplinary enforcement actions and to use 27 other legal means to recover funds; requiring the 28 department to establish by rule application procedures 29 and a process to verify the use of funds withdrawn 30 from a dental care access account; requiring the 31 department to give priority to applications from 32 dentists practicing in certain areas; requiring the 33 Department of Economic Opportunity to rank dental 34 health professional shortage areas and medically 35 underserved areas; requiring the Department of Health 36 to develop a marketing plan in cooperation with 37 certain dental colleges and the Florida Dental 38 Association; requiring the Department of Health to 39 annually submit a report with certain information to 40 the Governor and the Legislature; providing rulemaking 41 authority to require the submission of information for 42 such reporting; providing an effective date. 43 44 Be It Enacted by the Legislature of the State of Florida: 45 46 Section 1. Section 381.4019, Florida Statutes, is created 47 to read: 48 381.4019 Dental care access accounts.—Subject to the 49 availability of funds, the Legislature establishes a joint local 50 and state dental care access account initiative and authorizes 51 the creation of dental care access accounts to promote economic 52 development by supporting qualified dentists who practice in 53 dental health professional shortage areas or medically 54 underserved areas or who treat a medically underserved 55 population. The Legislature recognizes that maintaining good 56 oral health is integral to overall health status and that the 57 good health of residents of this state is an important 58 contributing factor in economic development. Better health, 59 including better oral health, enables workers to be more 60 productive, reduces the burden of health care costs, and enables 61 children to improve in cognitive development. 62 (1) As used in this section, the term: 63 (a) “Dental health professional shortage area” means a 64 geographic area so designated by the Health Resources and 65 Services Administration of the United States Department of 66 Health and Human Services. 67 (b) “Department” means the Department of Health. 68 (c) “Medically underserved area” means a geographic area so 69 designated by the Health Resources and Services Administration 70 of the United States Department of Health and Human Services. 71 (d) “Public health program” means a county health 72 department, the Children’s Medical Services Network, a federally 73 qualified community health center, a federally funded migrant 74 health center, or other publicly funded or nonprofit health care 75 program as designated by the department. 76 (2) The department shall develop and implement a dental 77 care access account initiative to benefit dentists licensed to 78 practice in this state who demonstrate, as required by the 79 department by rule: 80 (a) Active employment by a public health program located in 81 a dental health professional shortage area or a medically 82 underserved area; or 83 (b) A commitment to opening a private practice in a dental 84 health professional shortage area or a medically underserved 85 area, as demonstrated by the dentist residing in the designated 86 area, maintaining an active Medicaid provider agreement, 87 enrolling in one or more Medicaid managed care plans, expending 88 sufficient capital to make substantial progress in opening a 89 dental practice that is capable of serving at least 1,200 90 patients, and obtaining financial support from the local 91 community in which the dentist is practicing or intending to 92 open a practice. 93 (3) The department shall establish dental care access 94 accounts as individual benefit accounts for each dentist who 95 satisfies the requirements of subsection (2) and is selected by 96 the department for participation. The department may not 97 establish more than 10 new dental care access accounts per 98 fiscal year. The department shall implement an electronic 99 benefit transfer system that enables each dentist to spend funds 100 from his or her account for the purposes described in subsection 101 (4). 102 (4) Funds contributed from state and local sources to a 103 dental care access account may be used for one or more of the 104 following purposes: 105 (a) Repayment of dental school student loans. 106 (b) Investment in property, facilities, or equipment 107 necessary to establish and operate a dental office consisting of 108 no fewer than two operatories. 109 (c) Payment of transitional expenses related to the 110 relocation or opening of a dental practice which are 111 specifically approved by the department. 112 (5) Subject to legislative appropriation, the department 113 shall distribute state funds as an award to each dental care 114 access account. An individual award must be in an amount not 115 more than $100,000 and not less than $10,000, except that a 116 state award may not exceed 3 times the amount contributed to an 117 account in the same year from local sources. If a dentist 118 qualifies for a dental care access account under paragraph 119 (2)(a), the dentist’s salary and associated employer 120 expenditures constitute a local match and qualify the account 121 for a state award if the salary and associated expenditures do 122 not come from state funds. State funds may not be included in a 123 determination of the amount contributed to an account from local 124 sources. 125 (6) The department may accept contributions of funds from a 126 local source for deposit in the account of a dentist designated 127 by the donor. 128 (7) The department shall close an account no later than 5 129 years after the first deposit of state or local funds into that 130 account or immediately upon the occurrence of any of the 131 following: 132 (a) Termination of the dentist’s employment with a public 133 health program, unless, within 30 days of such termination, the 134 dentist opens a private practice in a dental health professional 135 shortage area or medically underserved area. 136 (b) Termination of the dentist’s practice in a designated 137 dental health professional shortage area or medically 138 underserved area. 139 (c) Termination of the dentist’s participation in the 140 Florida Medicaid program. 141 (d) Participation by the dentist in any fraudulent 142 activity. 143 (8) Any state funds remaining in a closed account may be 144 awarded and transferred to another account concurrent with the 145 distribution of funds under the next legislative appropriation 146 for the initiative. The department shall return to the donor on 147 a pro rata basis unspent funds from local sources which remain 148 in a closed account. 149 (9) If the department determines that a dentist has 150 withdrawn account funds after the occurrence of an event 151 specified in subsection (7), has used funds for purposes not 152 authorized in subsection (4), or has not remained eligible for a 153 dental care access account for a minimum of 2 years, the dentist 154 shall repay the funds to his or her account. The department may 155 recover the withdrawn funds through disciplinary enforcement 156 actions and other methods authorized by law. 157 (10) The department shall establish by rule: 158 (a) Application procedures for dentists who wish to apply 159 for a dental care access account. An applicant may demonstrate 160 that he or she has expended sufficient capital to make 161 substantial progress in opening a dental practice that is 162 capable of serving at least 1,200 patients by documenting 163 contracts for the purchase or lease of a practice location and 164 providing executed obligations for the purchase or other 165 acquisition of at least 30 percent of the value of equipment or 166 supplies necessary to operate a dental practice. The department 167 may limit the number of applicants selected and shall give 168 priority to those applicants practicing in the areas receiving 169 higher rankings pursuant to subsection (11). The department may 170 establish additional criteria for selection which recognize an 171 applicant’s active engagement with and commitment to the 172 community providing a local match. 173 (b) A process to verify that funds withdrawn from a dental 174 care access account have been used solely for the purposes 175 described in subsection (4). 176 (11) The Department of Economic Opportunity shall rank the 177 dental health professional shortage areas and medically 178 underserved areas of the state based on the extent to which 179 limited access to dental care is impeding the areas’ economic 180 development, with a higher ranking indicating a greater 181 impediment to development. 182 (12) The department shall develop a marketing plan for the 183 dental care access account initiative in cooperation with the 184 University of Florida College of Dentistry, the Nova 185 Southeastern University College of Dental Medicine, the Lake 186 Erie College of Osteopathic Medicine School of Dental Medicine, 187 and the Florida Dental Association. 188 (13)(a) By January 1 of each year, beginning in 2018, the 189 department shall issue a report to the Governor, the President 190 of the Senate, and the Speaker of the House of Representatives 191 which must include: 192 1. The number of patients served by dentists receiving 193 funding under this section. 194 2. The number of Medicaid recipients served by dentists 195 receiving funding under this section. 196 3. The average number of hours worked and patients served 197 in a week by dentists receiving funding under this section. 198 4. The number of dentists in each dental health 199 professional shortage area or medically underserved area 200 receiving funding under this section. 201 5. The amount and source of local matching funds received 202 by the department. 203 6. The amount of state funds awarded to dentists under this 204 section. 205 7. A complete accounting of the use of funds by categories 206 identified by the department, including, but not limited to, 207 loans, supplies, equipment, rental property payments, real 208 property purchases, and salary and wages. 209 (b) The department shall adopt rules to require dentists to 210 report information to the department which is necessary for the 211 department to fulfill its reporting requirement under this 212 subsection. 213 Section 2. This act shall take effect July 1, 2016.